1. Field of the Invention
A system, device and method for constricting aneurysms using a sleeve are provided.
2. Description of the Related Art
The treatment of aneurysms poses an operating problem, marked by high risk, high rates of death, long surgical procedure and a long recovery time.
An aneurysm is a bulge, a hernia of an artery. There are several types of aneurysm locations on an aorta: ascending, descending, thoracic and abdominal aortic aneurysms.
Surgical Repair of Aortic Aneurysms
Any aortic aneurysms that are large, causing symptoms or rapidly getting bigger are considered at risk of rupturing. Surgery is usually recommended if any one of these factors is present.
Both traditional surgery and endovascular aortic repair are used to treat aortic aneurysms. If surgery is needed, the doctor will make a large cut in the chest or abdomen. Then, the aneurysm will be removed and the damaged portion of the aorta will be replaced with a man-made graft. Some aortic aneurysms can be repaired without traditional surgery, using endovascular aortic repair. A stent graft is inserted through an artery in the groin. The stent graft makes a bridge between the healthy parts of the aorta (above and below the aneurysm).
At the present time, for any aortic aneurysms, a doctor will recommend surgery based on the following guidelines:                a. If the aneurysm is located where the aorta ascends up out of the heart, surgery is recommended when it reaches 5.5 to 6.0 cm in diameter.        b. If the aneurysm is located where the aorta begins to descend, surgery is recommended when it reaches 6.0 cm in diameter.        c. In those with Marfan's syndrome, surgery is recommended when the aneurysm reaches 5.5 cm in diameter.        d. If the aneurysm causes significant aortic regurgitation, surgery is recommended.        e. If the aneurysm is located in the thoracic or abdominal region, surgery is recommended when it reaches 5.5 to 6.0 cm in diameter.        f. The aorta is the major artery which arises from the heart. It carries all the blood that is pumped out of the heart and distributes it via its many branches to all the organs of the body. The aorta is divided into four portions: 1) the ascending aorta, 2) the aortic arch, 3) the descending aorta, 4) the thoracic aorta, and 5) the abdominal aorta.        
Surgeons and institutions around the world have differing experiences with aortic aneurysms and may follow different protocols in the treatment of the disease.
If surgery is chosen, the doctor will evaluate the overall health, including assessments of the heart, lungs, and circulatory system, the kidneys, and the gastrointestinal system. The decision whether to have surgery is based on the outcome of these evaluations. The risk of death or injury during the operation increases if other disease is present.
If the evaluation of the heart indicates that the patient has significant heart disease, the patient should undergo coronary artery bypass surgery (CABG) or coronary angioplasty prior to repairing an aortic aneurysm. This is because coronary artery disease is the most important underlying factor contributing to complications, such as heart attack, in the period before and after the operation. Other complications, such as stroke and infection of the graft, can also occur.
Kidney disease, chronic lung disease, and cirrhosis of the liver may raise the risk of death and complications during the operation.
Smoking and high blood pressure put a person at a higher risk for complications from surgery. They are also risk factors for the rupture of any aneurysms.
It is not an option to wait until an aneurysm has ruptured before surgery is done. Most people who have a ruptured aortic aneurysm die. Surgery for a ruptured aneurysm is dangerous because of the large amount of blood loss.
Two types of surgery are presently performed on aortic aneurysms:
1. The Traditional Surgery:
The affected portion of the Aorta is completely removed and replaced by a Dacron Tubing. The Dacron Tubing is stitched in different places. Many times, the stitches do not hold and one or more new operations need to be done.
2. Endovascular Aortic Repair:
The surgery is performed inside the aorta using thin, long tubes called stents. Through small incisions in the groin, the stents are used to guide and deliver a stent-graft through the blood vessels to the site of the aneurysm. The stent graft is then deployed in the diseased segment of the aorta.
An endovascular stent graft is a fabric tube supported by metal wire stents (also called a scaffold) that reinforces the weak spot in the aorta. By sealing the area tightly with the artery above and below the aortic aneurysm, the graft allows blood to flow through it without putting pressure on the aneurysm.
Endovascular repair of abdominal aneurysms is generally less painful and has a lower risk of complications than traditional surgery because the incisions are smaller. Endovascular aorta aneurysm procedures also allow a patient to leave the hospital sooner and make a faster recovery. However, possible complications of endovascular repair include:                Leaking of blood around the graft, known as “endoleak”;        Movement, or migration, of the graft away from its initial placement; and        Stent fracturing.        
Additional complications that are rare but serious include:                Paralysis;        Delayed rupture of the aneurysm; and        Infection.        
The long-term durability of endovascular stent grafting to treat an abdominal aneurysm is yet unknown because this is a fairly new procedure. For this reason, patients who have endovascular repair of their thoracic aneurysms must be monitored closely on a regular basis with examinations and imaging studies.
Blood vessel sleeves are known. U.S. Pat. No. 7,818,084 to Boyden et al discloses a method and system for making a blood vessel sleeve having dimensions based on blood vessel data from an individual, while U.S. Patent Application Publication No. 2008/0133040 to Boyden et al discloses methods and systems for specifying a blood vessel sleeve. Similarly, U.S. Patent Application Publication No. 2009/0024152 to Boyden et al., discloses a custom-fitted blood vessel sleeve.
Additionally, U.S. Patent Application Publication No. 2008/0188923 to Chu discloses methods and systems for preventing aneurysm rupture and reducing the risk of migration and endoleak, wherein an inflatable multiple wall liner is applied directly to treat the interior of the aneurysm site. U.S. Pat. No. 6,599,302 to Houser et al., discloses a system and components for treating aortic aneurysms including a reinforcing graft and fittings for securing the graft to a host vessel and to branch vessels. In Houser, combinations of fittings and rings or other compression mechanisms secure vessels or grafts frictionally, for end-end or end-side couplings.
Further, an article entitled “Enabling Sutureless Vascular Bypass Grafting With The Exovascular Sleeve Anastomosis” by D. W. Chang, et al., (J. Vasc. Surg.) (2000) 32:524-530, disclosed the use of an exovascular sleeve bypass graft that is drawn over an artery and secured in place with a cable tie.
What is needed is a simplified device, system and method for preventing an aneurysm in the walls of a vessel containing from growing or expanding and/or for restricting and/or constricting the walls of a vessel containing an aneurysm. What is additionally needed is a blood vessel sleeve device and system that can remain localized to a desired location and does not, itself, cause damage or chafing to the vessel or associated organs.